Incising Cell to Basement Membrane Bonds

ABSTRACT

Cells are attached to each other and to a basement membrane, to form a layer or layers. Cells may be separated from basement membrane without damaging the cells or basement membrane by the devices disclosed here. The devices enable simultaneous exposure of the cell basement membrane complex to light energy from both sides, the cells side and the basement membrane side. This simultaneous exposure of the cell basement membrane complex layer to specific levels of light energy from two sides causes incision of the bonds that attach the cells to the basement membrane.

FIELD OF INVENTION

The present invention discloses a device to incise bonds between cellsand basement membrane, without damaging the cell or the basementmembrane. The device enables exposure of the cell basement membranecomplex to specific intensity light energy from two directions, with thelight energy incident on the cell side of is of very low intensity, andthe light energy incident on the basement membrane side is of higherintensity, to achieve the incision of the bonds between them.

The effects of light on cell basement membrane complex depend onwavelength, intensity, duration of exposure, inherent composition of thetissue at the time of exposure, and on direction in which the exposureis affected. The application deals with achieving specific incision ofthe cell to basement membrane bonds by using very low intensity lightexposure from the cells side, simultaneous higher intensity exposurefrom the basement membrane side, with light energy of specificwavelengths.

BACKGROUND OF THE INVENTION

In laboratory procedures and in various surgical procedures, it isnecessary to effectively isolate cells which adhere to basementmembranes or capsules due to various reasons. Such isolation has to beeffective to prevent further complications or deterioration of themembrane or tissues, facilitate better visualisation of structures ortissue behind the cells or basement membranes, and to achieve opticaladvantages like for example, better staining for photographing thecells, and better manipulation for studying their properties.

There are several devices and methods as disclosed in the prior art,which aim to separate cells which adhere to the cell membranes.

The present invention relates to a device and a method, which overcomesthe various problems associated with prior Art. The invention embodiesdevices emitting light of selected wavelengths of low intensity forseparating epithelial cells. The device enables an operator to exposethe cell basement membrane complex to light energy from two directions,to achieve the desired effect of isolating epithelial cells from thebasement membrane to which they are attached. The effect is achieved byincising the bonds between cell and basement membrane.

The device can be employed in a number of therapeutic, laboratory andscientific procedures.

In the human body and in the laboratory, one comes across manysituations where the cells are lined up on a basement membrane in asingle layer or in many layers. For example, in the human eye, on thecorneal surface, the epithelium is arranged on a basement membranecalled the Bowman's membrane, in four to six orderly layers. Theattachments between the cells and the basement membrane is very strong.These epithelial cells ar very resistant to light that comes onto themfrom outside. However, we have found from our research, that theattachments of these cells to basement membrane are very fragile andvulnerable to light energy, if the light is directed onto theseattachements from the inner side, at low intensity when at the sametime, stronger light falls on the cells from the outer side.

In a mammal, lens epithelial cells of eye proliferate after the rest ofthe lens material is removed during cataract surgery. They may becomeopaque, and cause “after cataract” which affects vision. Some of thesecells change their character after surgery, become fibroblasts, and maycause fibrous scar formation in the capsule, giving rise to capsulecontraction syndrome. Even if the cells do not produce any of theseproblems, they cause opacification of the capsule, and hindervisualisation of the structures posterior to it. This makes treatmentand examination of the retina very difficult, for optical reasons.

It is desirable to remove these cells during cataract surgery to avoidall these problems in the postoperative period.

The cell membrane such as eye capsule is very thin and fragile. Thespace in which the surgeon has to work is very limited, and the capsulemust be spared along with the surrounding tissue, at all cost. The innerstructures of the eye do not tolerate any high-energy insults likechemicals, heat, electricity, laser, mechanical abrasions, etc.

The lens epithelial cells are attached to the capsule, from inside. Theydo not come out by simple washing as the attachment between the cellsand the capsule is very strong. If this attachment is loosened orsevered, the cells can be washed out easily, or may be sucked out by asimple tubular irrigating cannula attached to a syringe.

These cells can not be ablated by a laser device, because the cells willthen die and the dead cells will stick to the capsule, causing opticalproblems in the post operative period.

The prior Art in the field discloses various means for overcoming theproblem of removing the epithelial cells.

Some of the prior art discloses use of mechanical means to removeunwanted cells. The chief limitation of these methods is the possibilityof injury to the surrounding tissue.

International Patent Publication WO 00/49976, PCT/US00/04339 describes aNicapsulorhexis Valve. This is a silastic valve which will attach to thecapsulorhexis opening, in a water tight fashion. This excludes the restof the inner surface of the eye from contact with certain cytotoxicsubstances, which may be introduced into the capsular bag, to destroythe epithelial cells.

International Patent Publication WO 99/04729, deals with an IntraocularRing as a device. This disclosure deals with a physical gadget calledintra ocular ring, which kills the cells or prevents theirproliferation, by He pressure effect caused by its contact with thecells.

International Patent Publication WO 2004/039295 describes a method ofmaking a capsulorhexis in the lens capsule. The lens is removed from thelens capsule of an eye and the capsulorhexis is sealed with a sealingmeans/device, to provide gas leakage proof sealing. The lens capsule isexpanded with a gas and desired operation is performed inside the saidexpanded lens capsule.

Here, the inventor discloses a air tight sealing device seals thecapsular bag from the rest of the eye so that toxic gases or liquids maybe introduced into the bag to kill the cells.

U.S. Pat. No. 6,432,078 describes a System and Method for removingcataract or other cells in an eye using water jet and a suction. Itdiscloses a mechanical device to abrase, and then to suck the cells outof the eye, using water jet, mechanical brushes, etc.

International Patent Publication WO 98/25610/PCT/CA97/00949, disclosesuse of green porphyrins for the manufacture of a medicament for thetreatment of secondary cataracts. In this document, researchers from theUniversity of Columbia disclose certain chemical substances called greenporphyrins. These chemical substances are applied to the epithelialcells, and then irradiated with light, so that they destroy the cells towhich the substance is applied. This has called photodynamic therapy ofthe lens capsule.

Porphyrins are chemical substances, which must be introduced into theeye. The method is therefore not desirable.

International Patent Publication WO 99/39722, PCT/IB99/00905 disclosescompositions and methods for separating lens epithelial cells andpreventing posterior capsular opacification This is achieved bymodulating focal contacts, which mediate adhesion between lensepithelial cells and the lens capsule, using a treating solutioncontaining a focal contact-modulating substance or a proenzyme, such asLys-plasminogen, which is introduced into the eye.

International Patent Publication WO 02/047728, PCT/GB01/05465 disclosestreatment of posterior capsule opacification. This disclosure deals withkilling the cells with a chemical ligand. The ligand is preferably Fasligand. A spacer is preferably polyethylene glycol. The polymerpreferably constitutes an intraocular lens.

International Patent Publication WO 02/43632, PCT/AU01/01554 discloses adevice for sealing the capsular bag of an eye and a method fordelivering fluid or treatment substances to the lens of an eye. A methodis disclosed to seal the capsular bag from the rest of the eye, at thesame time allowing delivery of strong chemicals into the bag, to killthe cells.

U.S. Pat. No. 4,966,577 discloses a composition for preventing secondarycataract formation in the eye following removal of the lens, comprisingan antibody specific to particular lens cells related to secondarycataract formation, which antibody is conjugated to an antiproliferativeagent. The particularly preferred antiproliferative agents requireactivation after binding of the antibody to the target cells, andactivation may be accomplished by addition of a second composition or byexposure of the eye to electromagnetic energy. Also disclosed is amethod of using the composition by administering it directly to the sitefrom which the lens was removed to kill or prevent proliferation of lenscells.

This disclosure again specifies first, introduction of a chemicalsubstance, then introduction of another chemical substance, and thenactivation of this combination by use of electromagnetic energy, todestroy the cells of the capsule. U.S. patents U.S. Pat. No. 5,620,013U.S. Pat. No. 5,843,893, U.S. Pat. No. 5,627,162 disclose chemicalagents to destroy the cells of the capsule.

The chief limitation to chemical methods disclosed above is toxicity andadverse effects of the chemicals to the surrounding tissue.

International Patent Publication WO 01/54603, PCT/US01/03052 discloses asystem and method for treating cells of a site in the body, such as at alens capsule of an eye. The system and method employs an energy emittingdevice, and a positioning device, adapted to position the energyemitting device at a position in relation to the cells at the site inthe body, such as the cells of the lens capsule, such that energyemitted from the energy emitting device heats the cells to a temperaturewhich is above body temperature and below a temperature at which proteindenaturation occurs in the cells, to kill the cells or impedemultiplication of the cells. The energy emitting device can include acontainer containing a heated fluid which heats the cells to the desiredtemperature. The disclosures here deal with a method that heats thecells to denature or coagulate them, thereby destroying them.

International Patent Publication WO 98/18392, PCT/US96/17322 disclosesan instrument for destroying residual lens epithelial cells in a lenscapsule of an eye. The said instrument comprising of an electricalenergy source, a probe comprising an electrode, electrically coupled tosaid electrical energy source, and the said probe having a distal endportion configured for insertion into said eye between an iris of saideye and said lens capsule; and an insulating sleeve In this disclosure,the inventor discloses a method to electrically cauterise the capsulecells, so as to kill them.

The chief limitation of electrical methods is that the delicate tissuearound the cells may also get cauterised

U.S. Pat. No. 6,669,694 discloses medical instruments and techniques forhighly-localized thermally-mediated therapies. It describes delivery ofhigh thermal energy to the tissue to achieve an ablative effect on thecells.

U.S. Pat. No. 4,963,142 discloses an apparatus for endolasermicrosurgery. A method and apparatus for performing endolasermicrosurgery is disclosed, the apparatus including a laser deliverysystem coupled to a probe capable of transmitting the laser energythrough a suitable medium such as sapphire. The probe includes a coaxialcanal for aspiration of ablated tissue and/or fluids. The methodinvolves steps of ablating tissue by laser and aspirating the ablatedtissue and/or fluids, the method being useful for sclerostomy,vitrectomy and as a substitute for ultrasonic phacoemulsification amongothers. A probe for performing endolaser microsurgery and removingablated tissues is described. The apparatus disclosed here is meant todeliver laser energy, and to ablate the tissue, followed by removing theablated tissue.

The term ablation, is a geological term. By definition, it means“melting away” or removal away by melting or evaporation. The laserenergy described here is a means to achieve a high energy level, highenough to melt the tissue, and then to remove the ablated or meltedproducts. The achievement of high energy is done by using laser, whichallows very high energy concentration at a small area, for a short time,and achieves the melting with out damaging the surrounding tissue.

U.S. Pat. Nos. 6,238,386, 6,554,824, 6,582,421, 6,712,808, 6,726,680disclose an instrument that applies laser energy to human tissue.

U.S. Pat. No. 6,454,762 discloses an instrument for applying light,especially laser light, to the human or animal body. It describes aninstrument which consists of a movable tip, which enables light energyor laser energy from an external source to be directed to the desiredpart of the human body.

U.S. Pat. No. 6,238,386 discloses application of sound energy and laserenergy to internal body cavities by endoscope. The application of energyinside the human body by fiber optic delivery system. The laser used istherapeutic laser and supplies laser radiation at an optical power atsaid distal end which is at least 5 Watts or at an intensity at saiddistal end which is at least 1 kW cm.sup.-2. The power is disclosed tobe such as is required for coagulating tissue.

Muller discloses a device for using laser energy and sound energy fortreating inner body parts endoscopically, but the device uses energy, asstated above, to coagulate tissue. The minimum energy disclosed in thesaid invention is 5 watts. As 1 watt=408 lux ,the magnitude of energyused will be 2040 lux/cm.sup-2 or 2040,0000 lux/metersq.

The device disclosed in this application uses very low energy from thecell side, of a maximum of up to 1000 lux/sq mtr, simultaneously usinghigher energy from the basement membrane side. There is no coagulationat this energy levels. The device disclosed herein points the energy tothe cells basement complex simultaneously in two specific directions,from cell side and from the basement membrane side, to achieve thedesired effect.

The lasers involve high energy, and may cause thermal damage or thermalcoagulation of the tissue by raising the temperature of the tissue tohigh levels for a fraction of a second. However, the surrounding tissuecan also get ablated when high energy systems like lasers are used. Suchenergy will certainly damage the underlying capsule, if the epithelialcells were to be coagulated. It is well known that the capsule breaks atenergy levels of 1.2 millijoules, therefore, the disclosed device in thesaid invention can not be used in ophthalmology to separate epithelialcells from the capsule. This damages the cornea and the capsule itself.

LIMITATIONS OF PRIOR ART

The prior art cited above attempts to stop the problems associated withthe capsular epithelial cells by destroying them and then removing thecells by the following general means:

-   -   A. Mechanical means These methods disclose mechanical devices        for the removing the unwanted cells. The chief limitation of        these methods is the possibility of injury to the surrounding        tissue.    -   B. Chemical means. These methods use chemicals for removing the        cells. The chief limitation to this method is toxicity of these        chemicals to surrounding tissue.    -   C. Electrical means. The chief limitation is again, the delicate        tissue around the cells may also get cauterised.    -   D. Laser or Sonic methods/bright light sources The lasers        involve high energy, and achieves thermal damage or thermal        coagulation of the tissue by raising the temperature of the        tissue to high levels for a fraction of a second. However, the        surrounding tissue can also get ablated when high energy systems        like lasers are used. This damages the cornea and the capsule        itself.    -   The objective of gently isolating the cells from basement        membrane can not be achieved with a laser, because the        photocoagulated cells stick to the basement membrane, and cause        even stronger adhesion than before exposure to the laser.

SUMMARY OF THE INVENTION

The invention embodies a device that affects exposure of cell basementmembrane complex to specific low intensity light energy from onedirection viz from the cell side and higher light energy from thebasement membrane side simultaneously to affect isolation of these cellsfrom the basement membrane. The device may embody fiber optic tips ordelivery mirror, which enables the exposure of cells to the energy fromtwo specific directions simultaneously. The present invention overcomesthe various shortcomings of the prior art by providing a deviceembodying a low intensity light source and method/s to expose theepithelial cells in such manner as to loosen the attachment between theepithelial cells and the capsule. The removal of cells from the basementmembrane may be carried out by simple washing, if desired.

This is achieved by directly exposing the target cells to a pre-selectedvery low intensity light of wavelengths between 194 to 850 nanometers onthe cells side and simultaneously exposing the basement membrane side tohigher intensity light energy, by a device and a method. The lowintensity light is directed onto the cells from the cell side and notfrom the basement membrane side. The light is delivered to the cellsfrom inside, by almost actually touching the tip of the light sourcecarrier to the cell-capsule complex, and the distance between theepithelial cells and the light source is almost zero. The time ofexposure is less than 60 seconds. The basement membrane side of the cellbasement membrane complex is exposed to light energy of selectedspecific wavelengths between 194 nanometers and 850 nanometers. Thelight may be coherent or non coherent. The light that falls on the cellbasement membrane complex specified here is from the 194 to 850nanometers and the illuminance specified here of 0.002 to 5,00 000 lux.

The cells are extremely resistant to this light, if it comes from thenormal outer side, but extremely sensitive to this light if it isdirected to them from the inner side in the manner provided in theinvention. The basement membrane side of the cell basement membranecomplex must be exposed to a higher intensity light energy of theilluminance from 0.002 lux to 500000 lux.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a diagrammatic representation of low intensity device forseparating epithelial cells.

1 Light source for exposing the basement membrane side of the cellbasement membrane complex

2 Light source 2 for exposing the cells side of the cell basementmembrane complex.

3 Basement membrane

4 cells

FIG. 2 shows the device using a single external light, where a filterand attenuator regulate the intensity and wavelength of the lightfalling on the cell basement membrane complex from the basement membraneside and from the cell side, so that the exposure from the cell side isof very low intensity compared to the exposure from the basementmembrane side. The light is being carried by fiber optic cables.

1 Single light source

5 Fiber optic cable

6 Filter and attenuator and polariser to carry the light energy to thebasement membrane side of the complex.

7 Filter and attenuator and polariser to carry dimmer light of differentspecific spectral composition to the cell side of the cell basementmembane complex.

FIG. 3 Shows an external light, which falls on the basement membranedirectly, but is directed onto the cell side be a reflecting mirror. Theattenuators, filters and polarisers are depicted in a schematic manner,and shall be obvious to those skilled in the art. The exposure should besuch that the energy falling on the basement membrane side of the cellbasement membrane complex is higher than that falling on the cell sideof the cell basement membrane complex.

1 light source wavelength 194 to 1600 nanometers.

9 filter/polariser/attenuator

3 Basement membrane

4 cells

10 filters polarisers/attenuators

8 mirror

FIG. 4 Shows the exposure of the basement membrane from a light sourcefrom outside, which passes through the transparent cornea, and exposesthe outer side of the lens capsule to the light energy, whereas a fiberoptic carries light from another source, or the same source, butmodified by filters and attenuators and exposes the cell side of thecomplex to light energy. 11 external light source such as an aperatingmicroscope light source

12 light passing from the external light source onto the basementmembrane side of the tissue.

13 Fiber optic carrying the light energy from another light source orfrom the same light source, but attenuated and filtered, onto the otherside of the cell basement membrane complex, ie from the cells side.

14 The inner side or the cell side of the cell basement membrane complexis being exposed to the light carried there by the fiber optic, with asmooth atraumatic tip.

15 Cornea, which is transparent.

16 cut portion of the capsular bag called capsulorhexis opening.

17 Outer side of the capsular bag.

FIG. 5 shows smooth tip either in contact or close to the capsule Frominside. and shows curved tip, dual source device, with correct method ofexposure and placement of the device tip.

19,18 fiber optic light sources

16 capsule or basement membrane

17 cells lining the capsule from inside.

FIG. 6 shows two smooth curved hooks, made of fiber optic cords orencasing fiber optic cords. The smooth hooks are autraumatic, and thisis done to avoid injury to other biological structures which may beclose. The distance of the light carrier to the cells side of thecell—basement membrane complex is very dose to the cells.

20 Exposure to the basement membrane side of the basement membrane-cellcomplex by an atraumatic design smooth curved light transport system

21 basement membrane aspect being exposed.

22 Second light source exposing the cells side of the cell basementmembrane complex by another smooth surfaced atraumatic cannula

23 Cells side of the cell basement membrane complex.

The invention will now be described with reference to the FIGS. 1 to 6described above.

The device for incising cell basement membrane bonds consists of a lightsource (1), and a transport system (5,13,17,18) to carry this light intothe specific site, and if the basement membrane or capsule is shapedlike a curled bag or an envelope, to carry the energy into the capsularbag, through the opening into the bag. The tip of the transport system(14,20,22) where the instrument comes in contact with the capsule issmooth, and atraumatic.

In another embodiment, two light pipes carry light into the eye, onegoes into the inside of the capsular bag, and the other illuminates thecapsular bag from outside, as shown in sheet 5, labelled as parts 19,18.

Light Source

The light source may be coherent or non coherent, monochromatic ormultichromatic. It may be a LED, or may be laser source, arc lampsource, tungsten filament, light source, or any other light source daylight may be used and modified as a light source.

The light source may be white, or may be of colors. A white light sourcemay be converted into a source of certain pure colors by using filters.Single light source with filters may be used to create pure colorwavelengths and the inside of the capsule bag may be exposed to purecolors. A Mixed light source of white light may also be used. Wavelengthselected is between 194 to 850 nanometers.

Intensity is the critical part of the device. The intensity of the lightsource used in the invention must be such that the final incident lightwhich falls on the cells must be of very low intensity to produceilluminance of 0.001 lux to about 1000 lux. It may be noted that a 40watts domestic light bulb produces illuminance of thousands of lux ifmeasured very close to the surface of the bulb.

The light source may be switched or pulsed on and off several times asecond, in one of the preferred embodiments.

The light source may be more than one, so that cells are exposed todifferent wavelengths of light, alternately.

In combination with the first light source, there must be a second lightsource used. This may be an external light source of the surgicalmicroscope, or a totally different light source, by which, light iscarried onto the basement membrane. Such a light source may be a tinyLED, daylight which is modified by filters, optical focussing lenses, orpolarisers or attenuators, laser light source, external bulb lightsource.

In one of the preferred embodiments, such a light source is used with anilluminance of 0.002 lux to 500000 lux.

This second light source is mandatory and it must illuminate thebasement side of the cell basement membrane complex with illuminancehigher than that of the illuminance of the first light source whichworks from inner or cell side of the cell basement membrane complex. Theexposure should be simultaneous, to get the best effect. The secondlight source may be white, but may be of different colors.

To meet the condition that the energy incident on the basement membraneside is higher than that incident on the cells side, more than one lightsources may be used, to expose the basement membrane side of the cellbasement membrane complex.

If the first light source is white light, and if filters are used toproduce pure wavelengths to be delivered into the inside of the capsule,the first light source may be used also as the second light source, bybypassing the filters, and adding new filters and attenuators as shownin FIG. 2.

Delivery System

Fiber optic cable (5 in FIG. 2, 13 in FIG. 4, 18,19 in FIG. 5), orreflecting mirrors (8, in FIG. 3 ) are used to deliver the light energyto the cells directly. The fiber optic cable may be enclosed in atransparent water tight tubular cannula to avoid its contact with thetissues of the eye.

The tip of the cannula (14 in FIG. 4 and 20,22 in FIG. 6) is smooth,rounded, so that when it comes in contact with the under surface of thecapsule, it does not tear or damage it.

Method

During the actual procedure, after first, all debri and dirt that may bestuck to the cell basement membrane complex is cleaned by gentle suctionand wash. If the procedure is being carried out in a laboratory, in adish or a container, the liquid in which the cell basement membranecomplex is stored is kept free from dirt or insoluble floatingparticles. When the procedure is used inside the human body, like duringcataract surgery, the nucleus of the cataract is removed. The cortex iscleaned. The low intensity light is carried through the device into thecapsular bag, and the cells are exposed to it from inside. Themicroscope lamp may be used as a second light source for exposure fromthe basement membrane side. In a laboratory, the cell basement membranecomplex may be placed on a slide and exposed from both sides to thelight energy, with the energy from low intensity source falling directlyon the cells side. In the laboratory, when the procedure is performedunder a microscope, the microscope lamp may be used as the second brightsource, which will expose the basement membrane side to the higherenergy simultaneously. The cells are freed/separated by the exposure ofcell surface to low intensity and basement membrane surface to highintensity light from the device. The isolated epithelial cells can beremoved if desired by known methods such as simple wash and suction.

The device is effective by exposing the capsule cells to light from bothsides at the same time. One beam of light falls on the anterior capsulefrom outside. This beam is either from the source of light used by thesurgeon as an operating microscope, or a source of light locatedoutside, and brought on to the anterior surface of the capsule by alight pipe made of fiberoptic. The light which falls on the anteriorcapsule from outside may be of an illuminance from 0.002 lux to 500000lux.

However this outer beam of light alone does not form the device, thedevice must essentially contain the inner beam of light which fallssimultaneously onto the cells from inside, with specified lowillumination.

The light from the source which is used to treat the cells from insidethe capsule may be turned on and off one to fifteen times a second.

In another embodiment of the invention the light energy is transportedto the inside of the anterior capsule by a set of mirrors placed in abent pipe, so that instead of a fiber optic carrier, the light travelsthrough the hollow pipe and is turned into required path by thesereflecting mirrors and prisms.

In another embodiment of the invention the light source is directlycarried to the point where exposure of capsule cells is possible withoutpassing this light through fiber optic cable, by the use of reflectingmirrors as shown in FIG. 3.

The present invention, however, is not limited to any particularapplication or environment. Instead, those skilled in the art will findthat the present invention may be advantageously applied to anyapplication or environment using different low intensity light sourcesor combinations in multiple thereof, methods for applying such lowintensity light sources by any other direct or indirect methods ormeans, the use of mirrors or any other reflecting device. Thedescription of the exemplary embodiments, which follows, is therefore,for the purpose of illustration and not limitation.

Most Preferred Embodiment A. The Device

Two light sources, one comsisting of blue and red LEDs where the bluelight is 360 to 420 nanometers, and the red LED is from 700 to 850nanometers. The LEDs are pulsed from zero times a second to fifteentimes a second. This light source is used to expose the cell basementmembrane complex from inner or cell surface. The intensity is very low,so that illuminance on the cell surface is 0.001 to 1000 lux.

The second light source is the light directly used from a surgicalmicroscope. This light is used to illuminate the basement membrane sideof the cell basement membrane complex, directly, through the cornea. Tofacilitate exposure, the pupil is dilated by eye drops or mechanicallyby the surgeon, so that the iris moves out of the way of the secondlight source. The intensity used is such that the illuminance of thebasement membrane is 0.002 to 5,00,000 lux.

The light coming out of the first light source is picked up by a fiberoptic light pipe, which carries it to the inside of the eye.

The end piece of the fiber optic is a cannula (20,22 in FIG. 6) whosetip is transparent, and allows this light to be delivered to thecapsule.

B. Preferred Embodiment—Method

For the application of the low intensity device for separatingepithelial cells, the cannula is applied inside the capsular bag emptiedof the nucleus and the cortex, and the second light from the operatingmicroscope is allowed to fall on the basement membrane by eithermedically dilating the pupil preoperatively or by mechanically pullingthe iris away, by the surgeon. The capsule is touched from inside, withthe first cannula at many places, allowing the light from the device tofall momentarily on different regions of the capsule. Cells are loosenedand may even already start floating in the fluid in the anteriorchamber. These may be removed by known methods such as washing withgentle irrigation and aspiration, either with a hand held syringe andcannula, or with the automated system available with mostphacoemulsification machines.

In its most preferred embodiment, this device is different from themechanical devices disclosed in the prior art. The device of theinvention does not contain any movable parts, does not transmit any highintensity light onto the cells, and/transmits light of only certain welldefined wavelengths, for a well defined low intensity and for a welldefined period of time, specifically to a well defined part of the cellbasement membrane complex.

The device described in the application uses light energy, withspecified energy levels on the cell side which are several thousandtimes lower than those used by prior art. The energy delivery in theinvention does not aim to “coagulate” tissue, The device disclosed inthis application uses very low light energy on the cell side and higherenergy on the basement membrane side of the cell basement membranecomplex to gently separate or loosen the cells, by incising the bondsbetween cell and basement membrane so that the cells can be isolated.

The typical laser energies used in the prior art disclose energiesseveral thousand times more than the energy delivered as specified inthis application. The device disclosed in the application usesilluminance levels of 0.001 lux to a maximum of 1000 lux from the cellsside and simultaneously a higher illuminance levels of 0.002 lux to500000 lux.

from the capsule side or the outer side. The energy required in thedevice disclosed herein is 0.0000024 watts for illumination from inside

1. A device for incising bonds between cells and basement membrane orcapsule, comprising of a light source or sources, with specificwavelengths varying from 194 nanometers to 850 nanometers, with atransport system which simultaneously expose cell surface and basementmembrane surface of the cell basement membrane complex to two differentlevels of light energy with the energy exposure on the cell side of thecomplex being very low in intensity, and an optical carrying system thatcarries this light energy so that the epithelial cells lining thecapsule or basement membrane are exposed to the light emanating from thedevice directly without passing through the basement membrane so thatone of them applies light energy from the device to the epithelial cellsdirectly, without the energy having to pass through basement membrane.2. The device of claim 1 where the light source that directly exposesthe cells emits low light energy of a magnitude so low that the finalavailable energy where it acts on the capsule epithelial cells, isbetween 0.001 lux and 1000 lux.
 3. The device of claim 1 wherein thelight source that acts on the cells side of the cell basement membranecomplex is external and the light is carried to the capsule cells by afiber optic pipe, which allows passage of light energy between 194nanometers and 850 nanometers.
 4. The device of claim 1 where the lightsource that acts on the cells side of the cell basement membrane complexis directly carried to the point where exposure of capsule cells ispossible without passing this light through anterior or posteriorcapsules, by the use of reflecting mirrors.
 5. The device of claim 1where, if the basement membrane is like a bag or an envelop with thecells lining inside of the bag or envelop, the light energy istransported to the inside or cells side of the cell basement membranecomplex by a set of mirrors placed in a bent pipe, so that instead of afiber optic carrier, the light travels through the hollow pipe and isturned into required path by these reflecting mirrors and prisms.
 6. Thedevice of claim 1 where the light source itself is fitted into thehollow pipe so that it directly exposes the cells side of the cellbasement membrane complex in the interior of the capsular bag.
 7. Thedevice of claim 1 where the additional light source which illuminatesthe capsular bag from outside, so that the capsular bag is illuminatedfrom both inside and outside at the same time, is a coherent or noncoherent light from an external source. Which is either monochromatic orpolychromatic, with wavelengths between 194 to 850 nanometers. and withintensity such that the illuminance on the basement membrane is from0.002 lux to 5,00,000 lux.
 8. The device of claim 7 where the additionalsecond light source is that of an operating microscope or any otherexternal light.
 9. The device of claim 7 where, if the basement membraneis shaped like a bag or an envelope, the second light source is carriedby a fiber optic light source, directly onto the anterior or outersurface of the surface of the basement membrane or capsule.
 10. Thedevice of claim 7 where the second light source is carried onto theouter surface of the basement membrane or anterior capsule by usingreflecting mirrors placed into the eye.
 11. The device of claim 7 wherethe second light source is carried directly to the anterior or outersurface of the basement membrane placed over the membrane or capsule, toilluminate it directly.
 12. The device of claim 1 where, if the basementmembrane or capsule is shaped like a bag or an envelope, then the partof the device that goes into the capsular bag is smoothly turned into around tip.
 13. The device of claim 1 where the part of the device thatgoes into the capsular bag is turned into a round loop or sphere. 14.The method of using the device described in claim 1, by passing the tipof the device into the basement membrane, where the basement membrane orcapsule is shaped like a bag or envelope, pointing it towards thecapsular cells, and taking it very close to the cells, to touch themwith the tip of the device, and after, washing or aspirating the cellsout of the basement membrane complex by a conventional irrigationaspiration system.
 15. The method of using the device of claim 1, where,if the basement membrane is shaped like a bag or an envelop, the firstlight exposes the cells from inside the bag, and the second light sourceilluminates the basement membrane or capsule capsule from outside, byplacing the second tip on the outer or anterior surface of the basementmembrane or capsule.
 16. The device of claim 2 where the additionallight source which illuminates the capsular bag from outside, so thatthe capsular bag is illuminated from both inside and outside at the sametime, is a coherent or non coherent light from an external source, whichis either monochromatic or polychromatic, with wavelengths between 194to 850 nanometers and with intensity such that the illuminance on thebasement membrane is from 0.002 lux to 5,00,000 lux.
 17. The device ofclaim 3 where the additional light source which illuminates the capsularbag from outside, so that the capsular bag is illuminated from bothinside and outside at the same time, is a coherent or non coherent lightfrom an external source, which is either monochromatic or polychromatic,with wavelengths between 194 to 850 nanometers and with intensity suchthat the illuminance on the basement membrane is from 0.002 lux to5,00,000 lux.
 18. The device of claim 4 where the additional lightsource which illuminates the capsular bag from outside, so that thecapsular bag is illuminated from both inside and outside at the sametime, is a coherent or non coherent light from an external source, whichis either monochromatic or polychromatic, with wavelengths between 194to 850 nanometers and with intensity such that the illuminance on thebasement membrane is from 0.002 lux to 5,00,000 lux.
 19. The device ofclaim 5 where the additional light source which illuminates the capsularbag from outside, so that the capsular bag is illuminated from bothinside and outside at the same time, is a coherent or non coherent lightfrom an external source, which is either monochromatic or polychromatic,with wavelengths between 194 to 850 nanometers and with intensity suchthat the illuminance on the basement membrane is from 0.002 lux to5,00,000 lux.
 20. The device of claim 6 where the additional lightsource which illuminates the capsular bag from outside, so that thecapsular bag is illuminated from both inside and outside at the sametime, is a coherent or non coherent light from an external source, whichis either monochromatic or polychromatic, with wavelengths between 194to 850 nanometers and with intensity such that the illuminance on thebasement membrane is from 0.002 lux to 5,00,000 lux.